Provider Demographics
NPI:1114548898
Name:SIMS, HANNAH HOLDEN (LMT4401)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:HOLDEN
Last Name:SIMS
Suffix:
Gender:F
Credentials:LMT4401
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KILLEN
Mailing Address - State:AL
Mailing Address - Zip Code:35645-5701
Mailing Address - Country:US
Mailing Address - Phone:256-762-7267
Mailing Address - Fax:
Practice Address - Street 1:5752 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:KILLEN
Practice Address - State:AL
Practice Address - Zip Code:35645-8242
Practice Address - Country:US
Practice Address - Phone:256-272-1895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4401225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist